Active NPI
Paul R Whitwam MD PC
- Surgery Physician
- Roswell, NM
National Provider Identifier
1407962707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 73-226
- Legal business name
- PAUL R WHITWAM MD PC
- Practice address
- 1600 SE Main St Ste F
Roswell, NM 88203-5423 - Phone
- (575) 623-3333
- Fax
- (575) 623-1161
- NPI assigned
- Aug 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Cindy Vaughn
- Title
- Office Manager
- Phone
- (505) 623-1133
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 73-226 | NM | Primary |
Addresses
Primary practice location
1600 SE Main St Ste F
Roswell, NM 88203-5423
Mailing address
1600 SE Main St Ste F
Roswell, NM 88203-5423
Phone (575) 623-1133
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23424 | Medicaid | NM |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1198108800000",
"number": "1407962707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 SE MAIN ST STE F",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882035423",
"telephone_number": "575-623-1133",
"fax_number": "575-623-1161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SE MAIN ST STE F",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882035423",
"telephone_number": "575-623-3333",
"fax_number": "575-623-1161"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAUL R WHITWAM MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-21",
"last_updated": "2007-12-20",
"status": "A",
"authorized_official_last_name": "VAUGHN",
"authorized_official_first_name": "CINDY",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "505-623-1133",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": "NM",
"license": "73-226",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "23424",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.